NPIMap

Affinity Health Group, LLC

Organization Active NPI Clinical Medical Laboratory · Monroe, LA

NPI 1104274075 · NPPES record last updated Jun 1, 2016

Key facts

NPI
1104274075
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Medical Laboratory 291U00000X
Legal business name
AFFINITY HEALTH GROUP, LLC
Practice address
2516 Broadmoor Boulevard
Suite 1C
Monroe, LA 71201
Phone
(318) 807-4710
Fax
(318) 361-2195
NPI assigned
Jun 1, 2016
Organization subpart
No

Authorized official

Name
Ms. Janet Justice
Title
Director of Operations
Phone
(318) 807-7875

Other NPIs on the same Medicare enrollment 31

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 31

Corporate family (same tax ID) 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D0684544Baton Rouge Clinic Affinity Specialty Laboratory
2516 Broadmoor Blvd Suite 3B, Monroe, LA 71201		ComplianceApr 29, 2027
19D2113369Baton Rouge Clinic Affinity Specialty Urology
2516 Broadmoor Blvd a, Suite 3a, Monroe, LA 71201		Provider-performed microscopyMay 19, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080411000088 LA Part B Supplier - Clinic/Group Practice 9335226547 Receives reassigned benefits from 165 practitioners
38 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Monroe, LA; West Monroe, LA; Baton Rouge, LA

National Provider Directory

Tax ID family
Affinity Health Group (27 organizations share this tax ID)

Locations

2516 Broadmoor Blvd
Bldg A
Monroe, LA 71201

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Yes

Addresses

Primary practice location

2516 Broadmoor Boulevard
Suite 1C
Monroe, LA 71201

Mailing address

130 Desiard St
Suite 355
Monroe, LA 71201-7319
Phone (318) 807-7875

Other names

  • Affinity Specialty Lab & X-ray Doing business as

Other providers in Monroe, LA

All providers in Monroe, LA · Clinical Medical Laboratory in Louisiana

Sources for this page

Verify at the official NPI Registry.